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Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability
BACKGROUND: Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair. HYPOTHESIS: Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHOD...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665105/ https://www.ncbi.nlm.nih.gov/pubmed/29119123 http://dx.doi.org/10.1177/2325967117733660 |
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author | Delage Royle, Audrey Balg, Frédéric Bouliane, Martin J. Canet-Silvestri, Fanny Garant-Saine, Laurianne Sheps, David M. Lapner, Peter Rouleau, Dominique M. |
author_facet | Delage Royle, Audrey Balg, Frédéric Bouliane, Martin J. Canet-Silvestri, Fanny Garant-Saine, Laurianne Sheps, David M. Lapner, Peter Rouleau, Dominique M. |
author_sort | Delage Royle, Audrey |
collection | PubMed |
description | BACKGROUND: Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair. HYPOTHESIS: Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: A true anteroposterior (AP) view, alone and in combination with an axillary view, was used to evaluate the diagnostic properties of radiographs compared with computed tomography (CT) scan, the current gold standard, to predict significant bone defects in 70 patients. Sensitivity, specificity, and positive and negative predictive values were evaluated and compared. RESULTS: Detection of glenoid bone loss on plain film radiographs, with and without axillary view, had a sensitivity of 86% for both views and a specificity of 73% and 64% with and without the axillary view, respectively. For detection of humeral bone loss, the sensitivity was 8% and 17% and the specificity was 98% and 91% with and without the axillary view, respectively. Regular radiographs would have missed 1 instance of significant bone loss on the glenoid side and 20 on the humeral side. Interobserver reliabilities were moderate for glenoid detection (κ = 0.473-0.503) and poor for the humeral side (κ = 0.278-0.336). CONCLUSION: Regular radiographs showed suboptimal sensitivity, specificity, and reliability. Therefore, CT scan should be considered in the treatment algorithm for accurate quantification of bone loss to prevent high rates of recurrent instability. |
format | Online Article Text |
id | pubmed-5665105 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-56651052017-11-08 Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability Delage Royle, Audrey Balg, Frédéric Bouliane, Martin J. Canet-Silvestri, Fanny Garant-Saine, Laurianne Sheps, David M. Lapner, Peter Rouleau, Dominique M. Orthop J Sports Med 53 BACKGROUND: Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair. HYPOTHESIS: Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: A true anteroposterior (AP) view, alone and in combination with an axillary view, was used to evaluate the diagnostic properties of radiographs compared with computed tomography (CT) scan, the current gold standard, to predict significant bone defects in 70 patients. Sensitivity, specificity, and positive and negative predictive values were evaluated and compared. RESULTS: Detection of glenoid bone loss on plain film radiographs, with and without axillary view, had a sensitivity of 86% for both views and a specificity of 73% and 64% with and without the axillary view, respectively. For detection of humeral bone loss, the sensitivity was 8% and 17% and the specificity was 98% and 91% with and without the axillary view, respectively. Regular radiographs would have missed 1 instance of significant bone loss on the glenoid side and 20 on the humeral side. Interobserver reliabilities were moderate for glenoid detection (κ = 0.473-0.503) and poor for the humeral side (κ = 0.278-0.336). CONCLUSION: Regular radiographs showed suboptimal sensitivity, specificity, and reliability. Therefore, CT scan should be considered in the treatment algorithm for accurate quantification of bone loss to prevent high rates of recurrent instability. SAGE Publications 2017-10-30 /pmc/articles/PMC5665105/ /pubmed/29119123 http://dx.doi.org/10.1177/2325967117733660 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | 53 Delage Royle, Audrey Balg, Frédéric Bouliane, Martin J. Canet-Silvestri, Fanny Garant-Saine, Laurianne Sheps, David M. Lapner, Peter Rouleau, Dominique M. Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title | Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title_full | Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title_fullStr | Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title_full_unstemmed | Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title_short | Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability |
title_sort | indication for computed tomography scan in shoulder instability: sensitivity and specificity of standard radiographs to predict bone defects after traumatic anterior glenohumeral instability |
topic | 53 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665105/ https://www.ncbi.nlm.nih.gov/pubmed/29119123 http://dx.doi.org/10.1177/2325967117733660 |
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